Approach Considerations

Remain aware of the complications of asbestosis in order to expedite detection and treatment. Inform patients about the work-related causation of the disease (potentially compensable) and report it to appropriate state or federal agencies. Additionally, advise smokers to quit smoking, and provide referral to a smoking cessation clinic.

Assessment of disease severity and functional impairment are important in tailoring a treatment and follow-up plan (ie, frequency of clinic visits, chest radiographs, pulmonary function testing).

The treatment of asbestosis requires prompt antimicrobial therapy for respiratory infections, as well as immunization against influenza and pneumococcal pneumonia.

Assess the patient’s oxygenation status at rest and with exercise. If hypoxemia at rest or with exercise is detected, prescribe supplemental oxygen.

Medications

Drugs are not effective in the treatment of asbestosis. Corticosteroids and immunosuppressive drugs do not alter the course of the disease.

Prevention and deterrence

The control of asbestos in the workplace is the most effective method for preventing asbestosis. Cessation of further exposure to asbestos once the diagnosis of asbestosis is made is imperative because additional exposure increases the rate of progression. However, the disease may progress even after exposure has stopped.

Consultations

Consult a pulmonologist to assess the need for long-term oxygen therapy and for the management of advanced cases and complications. Because of the likelihood of bronchogenic carcinoma, consult a thoracic surgeon if a solitary pulmonary nodule develops in a patient with asbestosis.